On July 28, Senator Bernie Sanders and Rep. Jeff Miller announced a bi-partisan agreement on legislation to address the ongoing issues with veteran’s access to health care at the Department of Veterans Affairs (VA).  The legislation, “The Veterans’ Access to Care Act of 2014,” would allow veterans to seek care outside of the VA system if they live too far from VA clinics or if wait times at local clinics are too long and increases funding to hire additional staff. 

This compromise overcame issues on how much the legislation is projected to cost and how to pay for it, and it is likely to pass through Congress before both chambers adjourn for August recess.

Below, this post will take a look at how this legislation affects OT. 

Access to Care Outside of the VA:

Veterans will be able to seek care from non-VA facilities and providers including providers participating in Medicare, Federally-qualified health centers (FQHC), the Department of Defense, and the Indian Health Service.  Veterans that cannot obtain an appointment within current wait time goals, generally 14 days, or live more than 40 miles from a VA facility will be eligible.

Reimbursement rates are limited to Medicare rates with increases available only in highly rural areas.

Staffing Shortages:

This bill provides $5b to hire additional staff and upgrade and operate VHA facilities, and it removes bureaucratic barriers that frequently delay the hiring process.

Additionally, the Health Professionals Educational Assistance Program is reauthorized through 2019 and the lifetime cap on per person debt reduction payments is lifted from $60,000 to $120,000 and the yearly cap lifted from $12,000 to $24,000. OT’s and OTA’s are eligible for loan reimbursement under this program at VHA Medical Centers.  

Pilot Programs:

The Assisted Living Pilot Program for Veterans with TBI, which was due to end in September, is extended through March 2015. This allows veterans to access rehabilitation services in residential settings, including occupational therapy, to help veterans return home rather than be placed in an institutional setting.

The agreement also extends Project ARCH (Access Received Closer to Home), a pilot program to provide health care services, including occupational therapy, through contractual arrangements with non-VA care providers, for another two years.

Occupational therapy practitioners work with veterans as active duty, reserve, and civilian OTs inside and outside the VA. This legislation provides increased opportunities for OT practitioners to treat veterans, including those with traumatic brain injury (TBI) and the growing number of veterans with poly-trauma (e.g., an amputation, TBI, and post-traumatic stress disorder).